Mineralocorticoid receptor antagonists in HFpEF patients improved indices of cardiac structure and function, but decreased 6-min walk distance (-11.56 m) and increased serum potassium (0.23 mmol/L).
Meta-Analysis
Does MRA treatment improve cardiac function in patients with HFpEF?
MRA therapy in HFpEF improves cardiac structure and function but is associated with increased serum potassium and a slight reduction in exercise capacity.
, - 1.91 to - 0.33), 6-min walk test distance (- 11.56 m, - 21 to - 2.13), systolic (- 4.75 mmHg, - 8.94 to - 0.56) and diastolic blood pressure (- 2.91 mmHg, - 4.15 to - 1.67), and increased levels of serum potassium (0.23 mmol/L, 0.19 to 0.28) when compared with placebo/control. In patients with HFpEF, MRA treatment significantly improves indices of cardiac structure and function, suggesting a decrease in left ventricular filling pressure and reverse cardiac remodeling. MRA increase serum potassium and decrease blood pressure; however, a small decrease in 6-min-walk distance is also noted. Larger prospective studies are warranted to provide definitive answers on the effect of MRA in patients with HFpEF.
Kapelios et al. (Mon,) conducted a meta-analysis in Heart failure and preserved ejection fraction (HFpEF). Mineralocorticoid receptor antagonists (MRA) vs. Placebo/control was evaluated. Mineralocorticoid receptor antagonists in HFpEF patients improved indices of cardiac structure and function, but decreased 6-min walk distance (-11.56 m) and increased serum potassium (0.23 mmol/L).